Treatment of refractory kidney transplant ureteral strictures using balloon cautery endoureterotomy

Schwartz, Bradley F.; Chatham, James R.; Bretan, Peter N.; Goharderakhshan, Reza Z.; Stoller, Marshall L.

doi:10.1016/s0090-4295(01)01275-4

Cited by 37 publications

(14 citation statements)

References 16 publications

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“…However, a few small studies have detailed its use for ureterovesical strictures following transplantation [12, 13]. A total of 21 patients were treated with follow-up ranging from 13 to 27 months (mean 19 months).…”

Section: Resultsmentioning

confidence: 99%

The Current Role of Endourologic Management of Renal Transplantation Complications

Duty

Conlin

Fuchs

et al. 2013

Advances in Urology

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Introduction. Complications following renal transplantation include ureteral obstruction, urinary leak and fistula, urinary retention, urolithiasis, and vesicoureteral reflux. These complications have traditionally been managed with open surgical correction, but minimally invasive techniques are being utilized frequently. Materials and Methods. A literature review was performed on the use of endourologic techniques for the management of urologic transplant complications. Results. Ureterovesical anastomotic stricture is the most common long-term urologic complication following renal transplantation. Direct vision endoureterotomy is successful in up to 79% of cases. Urinary leak is the most frequent renal transplant complication early in the postoperative period. Up to 62% of patients have been successfully treated with maximal decompression (nephrostomy tube, ureteral stent, and Foley catheter). Excellent outcomes have been reported following transurethral resection of the prostate shortly after transplantation for patients with urinary retention. Vesicoureteral reflux after renal transplant is common. Deflux injection has been shown to resolve reflux in up to 90% of patients with low-grade disease in the absence of high pressure voiding. Donor-gifted and de novo transplant calculi may be managed with shock wave, ureteroscopic, or percutaneous lithotripsy. Conclusions. Recent advances in equipment and technique have allowed many transplant patients with complications to be effectively managed endoscopically.

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Section: Resultsmentioning

confidence: 99%

The Current Role of Endourologic Management of Renal Transplantation Complications

Duty

Conlin

Fuchs

et al. 2013

Advances in Urology

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“…[11][12][13]15 All published series have incorporated small numbers of patients, and long-term follow-up is still unavailable.…”

Section: Discussionmentioning

confidence: 99%

“…Small series describing endourologic management of transplant ureteral stenoses have been reported, with various degrees of success. [4][5][6][7][8][9][10][11][12][13][14][15] Herein, we describe our experience with balloon dilation of strictured ureteroureterostomies and Acucise catheter (Applied Medical Resources, Rancho Santa Margarita, CA) incision of strictured ureterovesical anastomoses.…”

Section: Introduction S Tenosis Of the Transplant Ureter Anasto-mentioning

confidence: 99%

Transplant Ureter Stricture: Acucise Endoureterotomy and Balloon Dilation are Effective

Bhayani

Landman

Slotoroff

et al. 2003

Journal of Endourology

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“…The definitive treatment depends on the severity of the stenosis, location of the stenosis, and the developmental stage of the stenosis. Endoscopic transurethral or percutaneous interventions and surgery in unresponsive cases are among the treatment options (2,10,11).…”

Section: Ureteral Stenosismentioning

confidence: 99%

Management of Renal Transplant Patients in the Emergency Department

Ergin¹,

Dal²,

Granit³

et al. 2015

JAEM

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Solid organ transplant patients constitute a special population in the emergency departments (EDs). Increasing numbers of patients are reported in EDs for transplantation-related complications. Complications related to organ transplantation can be categorized into four groups: anatomical, infection, rejection, and drug toxicity. In patients presenting to the ED, all these categories should be considered in the differential diagnosis. However, the exact etiology, may not be known until admission to the hospital for further evaluation. Therefore, every complaint from a transplant patient should be carefully evaluated. In this study, we will review the principles for the management of patients with renal transplantation in the ED. (JAEM 2015; 14: 83-7) Keywords: Renal failure, transplantation, emergency care IntroductionOrgan transplantation is one of the most significant achievements in medicine for treating patients with end-stage organ failure. As a result of its success, increasing numbers of patients are reported in the emergency departments (EDs) for transplantation-related complications. Solid organ transplant patients constitute a special population in the ED. In this study, we will review the principles for the management of patients with renal transplantation in the ED.The transplanted kidney lacks the native nerve innervations of its donor, and it is connected to multiple organs with surgical anastomosis. As a result, pain is an unreliable indication of the underlying pathology. Furthermore, it is important to consider the anatomical association of the transplanted organ in order to understand leaks and blockages that can occur at the sites of anastomosis. Vague signs and symptoms may develop as a result of inflammation and immunological responses to infection and malignancy. Therefore, every complaint from a transplant patient should be carefully evaluated. When major complaints are present, knowledge of the initial physiological condition of the allograft can help to rule in or rule out possible organ failure. Even minor changes in allograft functioning can indicate organ failure. The duration of time since the organ transplantation should always be considered when evaluating the patient's condition (1-3). Complications of Renal TransplantationOrgan transplantation-related complications can be categorized into four groups: anatomical, infection, rejection, and drug toxicity. In patients presenting to the ED, all these categories should be considered in the differential diagnosis. However, the exact etiology, may not be known until admission to the hospital for further evaluation (1, 2). A. Complications Related to Transplantation TechniqueTransplantation technique-related complications can develop during the preparation for transplantation and during the surgery. They can be divided into early-and late-stage complications (2). Early-stage complicationsEarly-stage complications can develop immediately after the surgical procedure or during the early postoperative period. They include general ...

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Treatment of refractory kidney transplant ureteral strictures using balloon cautery endoureterotomy

Cited by 37 publications

References 16 publications

The Current Role of Endourologic Management of Renal Transplantation Complications

The Current Role of Endourologic Management of Renal Transplantation Complications

Transplant Ureter Stricture: Acucise Endoureterotomy and Balloon Dilation are Effective

Management of Renal Transplant Patients in the Emergency Department

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